Tailored Interactive Multimedia to Reduce Colorectal CA Screening Disparities

背景：交互式多媒体计算机程序（IMCP）显示出作为一种传递 个人定制（PT）信息，以增强健康行为的认知介导因子，并改善患者 结果。然而，目前尚不清楚PT IMCP是否可以部署在初级保健办公室，以增加 通过在每个用户的 首选语言目的/假设：我们将比较CRC筛查认知介质（自我- 有效性，感知障碍和准备）和IMCP产生的吸收  PT增强键 认知介质，并针对患者的自我确定的种族-与变化所造成的非- 量身定制的“电子传单”控制IMCP。实验和对照IMCP将分别以英语提供 西班牙语版本。我们假设，与适当的控制条件（英语， 西班牙语，或两者结合）：（1）英语版的PT IMCP将增强认知介质， 讲英语的西班牙裔和非西班牙裔的CRC筛查行为;（2） 使用PT IMCP西班牙语版本的西班牙裔的这些调解人的变化;（3）PT IMCP的部署 IMCP将提供消除西班牙裔和非西班牙裔之间CRC筛查差异的证据 受试者通过其对这些群体中认知介质的相对影响;和（4）PT IMCP（英语和 西班牙语合并）将增加西班牙裔和非西班牙裔的CRC筛查摄取（考虑 分别）通过认知介质的变化。方法：随机对照试验， 比较PT（与认知介质）CRC筛查IMCP（英语和西班牙语） 版本，并部署在初级保健办公室访问与非定制的“电子传单”CRC筛查 IMCP（控制）也提供英语和西班牙语。筛查方法的目标将是粪便潜血 测试，乙状结肠镜检查，结肠镜检查。主要结局将是CRC筛查的接受率、自我- 有效性、感知障碍和准备程度。影响：我们的研究结果将确定是否IMCP， PT为筛查行为的认知介导因子，并在之前的初级保健办公室部署 定期访问可以激活不同种族的患者进行CRC筛查。他们还可能建议 一种有前途的，便携式的方法，减少西班牙裔之间CRC（和其他）筛查摄取的差异， 和非西班牙裔人。项目叙述：我们的研究结果将决定一个交互式多媒体计算机程序， 针对筛查行为的认知介导者量身定制，并在 先前安排的访问可以激活不同种族的患者进行结肠直肠癌筛查。 他们还可能提出一种有希望的、便携式的方法来减少结直肠癌（和其他）的差异。 西班牙裔和非西班牙裔个体之间的筛查摄取。

Background: Interactive multimedia computer programs (IMCPs) show promise as a way of delivering personally tailored (PT) information to enhance cognitive mediators of health behavior and improve patient outcomes. However, it is unclear whether PT IMCPs can be deployed in primary care offices to increase cancer screening uptake and eliminate ethnic disparities in uptake by providing PT information in each user's preferred language. Aims/Hypotheses: We will compare changes in CRC screening cognitive mediators (self- efficacy, perceived barriers, and readiness) and uptake resulting from an IMCP  PT to enhance the key cognitive mediators and targeted to patients' self-identified ethnicity - with changes resulting from a non- tailored "electronic leaflet" control IMCP. The experimental and control IMCPs will each be offered in English and Spanish versions. We hypothesize that, compared with the appropriate control condition (English, Spanish, or both combined): (1) the English version of the PT IMCP will enhance the cognitive mediators of CRC screening behavior for English-speaking Hispanics and non-Hispanics; (2) there will be similarly favorable changes in these mediators for Hispanics using the Spanish version of the PT IMCP; (3) deployment of the PT IMCP will provide evidence of elimination of disparities in CRC screening between Hispanic and non-Hispanic subjects via its relative impact on the cognitive mediators in these groups; and (4) the PT IMCP (English and Spanish combined) will increase CRC screening uptake in Hispanics and non-Hispanics (considered separately) via changes in the cognitive mediators. Methods: Randomized controlled trial of 2 groups, comparing a PT (to the cognitive mediators) CRC screening IMCP offered in both English and Spanish versions and deployed before a primary care office visit with a non-tailored "electronic leaflet" CRC screening IMCP (control) also offered in both English and Spanish. Screening methods targeted will be fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy. Primary outcomes will be CRC screening uptake, self- efficacy, perceived barriers, and readiness. Implications: Our findings will determine whether an IMCP that is PT to cognitive mediators of screening behavior and deployed in primary care offices prior to previously scheduled visits can activate patients of various ethnicities to undergo CRC screening. They may also suggest a promising, portable method of reducing disparities in CRC (and other) screening uptake between Hispanic and non-Hispanic individuals. Project Narrative: Our findings will determine whether an interactive multimedia computer program that is personally-tailored to cognitive mediators of screening behavior and deployed in primary care offices prior to previously scheduled visits can activate patients of various ethnicities to undergo colorectal cancer screening. They may also suggest a promising, portable method of reducing disparities in colorectal cancer (and other) screening uptake between Hispanic and non-Hispanic individuals.